Provider Demographics
NPI:1720516362
Name:TIFFANY ZARIFKAR, LMHC, LLC
Entity Type:Organization
Organization Name:TIFFANY ZARIFKAR, LMHC, LLC
Other - Org Name:MOUNT VERNON FAMILY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARIFKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, NCC
Authorized Official - Phone:319-693-2266
Mailing Address - Street 1:104 2ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:IA
Mailing Address - Zip Code:52314-1301
Mailing Address - Country:US
Mailing Address - Phone:319-693-2266
Mailing Address - Fax:
Practice Address - Street 1:104 2ND AVE NW
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:IA
Practice Address - Zip Code:52314-1301
Practice Address - Country:US
Practice Address - Phone:319-693-2266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-26
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001373261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0707139Medicaid